Emily Bacon, Matthew Tabbut
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.031
Publication stage: In Press Corrected Proof
Published online: November 17 2015
x Peritonsillar abscess is a common presentation in the emergency department and is often diagnosed clinically. However, not everything that presents as a peritonsillar fluid collection is an abscess. We describe a case of sore throat and peritonsillar swelling that clinically appeared as a peritonsillar abscess, but bedside ultrasound revealed a different pathology. It is important that emergency physicians recognize this potential and include emergency physician performed bedside ultrasound as an instrumental component of the diagnosis.
James Penn, Meghan Nahass, Ranita Sharma
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.021
Publication stage: In Press Corrected Proof
Published online: November 10 2015
x In the emergency department setting, new onset ST-segment elevations with concurrent chest or epigastric pain typically indicate an acute coronary syndrome. ST-segment elevations can also been seen in a number of other conditions, such as pericarditis, coronary vasospasm, or increased intracranial pressure [1]. An uncommon but increasingly cited cause of ST-segment elevations is hypercalcemia. The cases of hypercalcemia-induced ST-segment elevations have had various causes including malignancy, supplements, thiazide diuretic use, and primary hyperparathyroidism, none of which are associated with concurrent chest or epigastric pain.
Ayse Gultekingil Keser, Ozlem Teksam, Hayriye Hızarcıoğlu Gulsen, Burcu Berberoğlu Ates, İnci Nur Saltık-Temizel, Hülya Demir
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.016
Publication stage: In Press Accepted Manuscript
Published online: November 9 2015
x Gastrointestinal bleeding is a common problem in pediatric emergency department(PED). Some of these patients can lose significant amount of blood which may lead to shock. The aim of this study is to determine the risk factors predicting clinically significant gastrointestinal(GIS) bleeding in patients presenting to PED.
Jing Cao, Yilin Liu, Yuqiang Wang, Limin Wang, Min Zhang, Min Feng, Hong Luo, Yanli Ma, Xiaoxu Hou
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.019
Publication stage: In Press Corrected Proof
Published online: November 9 2015
x Distal femur fracture is a major risk factor for pulmonary embolism (PE) [1,2]. Because of to the disease frequently presenting with rapid hemodynamic deterioration, massive pulmonary embolism (MPE) during the operation is a common life-threatening illness associated with poor clinical outcome. It is a primary cause of hospital morbidity and mortality [3]. The optimal treatment of MPE is controversial, although various methods have been developed and improved.
Yingyi Zhang, Defan Kang, Baoxi Zhang, Lin Yang, Zhe Fan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.011
Publication stage: In Press Corrected Proof
Published online: November 9 2015
x Primary splenic pregnancy is a rare form of ectopic pregnancy. We report an unusual and rare case in a patient who was diagnosed with primary splenic pregnancy rupture. The disease should be considered as a differential diagnosis of acute abdomen for women.
Hesham R. Omar, Mehdi Mirsaeidi, Ehab El-Khabiry, Devanand Mangar, Enrico M. Camporesi
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.018
Publication stage: In Press Corrected Proof
Published online: November 9 2015
x We simultaneously recorded right- and left-sided electrocardiogram (ECG) in a patient with confirmed acute pulmonary embolism in an attempt to study the value of right-sided ECG in detecting right ventricular dilation/strain. We present the case and describe several diagnostic and prognostic implications highlighting the value of right-sided ECG in cases with suspicion or confirmed acute pulmonary embolism.
Eben Clattenburg, Andrew Herring, Christoper Hahn, Brian Johnson, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.002
Publication stage: In Press Corrected Proof
Published online: November 3 2015
x Calcaneal fracture is a common injury that often results in severe, difficult-to-treat pain. Increasingly, emergency practitioners are asked to both improve pain management and reduce use of opioid pain relievers. Moreover, opioid monotherapy is often inadequate to safely control the pain of acute bone fractures. Ultrasound-guided nerve blocks integrated into a multimodal approach are increasingly recognized as the criterion standard for acute pain control in extremity trauma. We reviewed the neuroanatomy of the calcaneous and hypothesized that a selective posterior tibial nerve block would provide clinically significant relief for emergency department patients with acute calcaneal fracture pain.
David W. Neilly, Santosh Baliga, James Bidwell, Kapil Kumar
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.043
Publication stage: In Press Corrected Proof
Published online: October 26 2015
x We present the case of a 55-year-old man with an anterior shoulder dislocation with a body mass index of greater than 70 and successful closed reduction. We discuss the management strategy and technical and logistical considerations. The use and positioning of fluoroscopy is essential, as the usual 'clunk' is not always present. Care of patients with extremely high body mass index poses several challenges to the Trauma team. These patients should be scheduled for reduction under general anesthetic in theatre during daylight hours on a planned list, and the team involved must have the expertise available to proceed to open reduction and stabilisation if required.
Yu-Ren Lin, Chang-Chih Shih, Hsiang-Cheng Chen, Sy-Jou Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.042
Publication stage: In Press Corrected Proof
Published online: October 26 2015
x A 19-year-old woman presented with symptoms of persistent and relapsing hiccups for 2 months, followed by a swallowing dysfunction that deteriorated to acute respiratory failure. Brain magnetic resonance imaging showed hyperintense areas in the posterior medulla and left inferior cerebellar peduncle in a T2-weighted image, suggesting demyelinating lesions. Sjogren syndrome was diagnosed based on subsequent positive tests of antinuclear and anti-Ro antibodies as well as salivary scintigraphy examinations.
Alex Smetana, Brian Driver, Srdjan Gajic, Stephen Smith
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.040
Publication stage: In Press Corrected Proof
Published online: October 26 2015
x We present 2 cases of partial segmental thrombosis of the corpus cavernosum (PSTCC) diagnosed in our emergency department within a 2-month period, including 1 case in which the emergency physician was able to detect a corpus cavernosal abnormality using bedside ultrasonography. Initial diagnosis of PSTCC should be made by ultrasound, followed by confirmatory magnetic resonance imaging. An emergency physician with access to bedside ultrasonography should be able to identify proximal corpora cavernosa abnormalities including corpora cavernosa asymmetry and possible absence of color Doppler flow in the thrombosed segment.
Christopher B. Adams, Kristan E. Vollman, Evan L. Leventhal, Nicole M. Acquisto
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.041
Publication stage: In Press Corrected Proof
Published online: October 26 2015
x Emergent reversal of anticoagulation is a common clinical scenario in emergency medicine but infrequently involves a pediatric patient. We describe the use of a 4-factor prothrombin complex concentrate in a pediatric patient presenting with acute bleeding and an elevated international normalized ratio secondary to a vitamin K antagonist (warfarin). The complexities of the hemostatic system maturation are briefly discussed along with the difficulties associated with extrapolating the adult 4-factor prothrombin complex concentrate dose to the pediatric population.
Narat Srivali, Patompong Ungprasert, Charat Thongprayoon, Wisit Cheungpasitporn
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.048
Publication stage: In Press Accepted Manuscript
Published online: August 31 2015
x This article has been retracted/withdrawn: Please see Elsevier Policy on Article Withdrawal ( http://www.elsevier.com/locate/withdrawalpolicy ). This article has been retracted at the request of the corresponding author, Dr. Srivali, due to a potential ethical issue regarding consent.
Hyung Jun Moon, Il Woong Hwang, Jung Won Lee, Sae Yong Hong
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.044
Publication stage: In Press Accepted Manuscript
Published online: August 28 2015
x Lipid emulsions are an important component of parenteral nutrition. In recent years, the use of Intravenous lipid emulsion (ILE) as a useful adjunct to antidotal therapy in treatment of lipophilic medication overdoses has increased since first discovered. Rapid or chronic infusion of an ILE reportedly causes fat overload syndrome. However, cases of fat overload syndrome with rapid infusion of a 20% soy oil, medium-chain triglyceride, olive and fish oil–based lipid emulsion (SMOFlipid) are not reported in adult patients.
Peter W. Greenwald, Rosa M. Estevez, Sunday Clark, Michael E. Stern, Tony Rosen, Neal Flomenbaum
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.041
Publication stage: In Press Corrected Proof
Published online: May 30 2015
x The elderly population in the United States is growing. This age shift has important implications for emergency departments (EDs), which currently account for more than 50% of inpatient hospitalizations. Our objective was to compare the percentage of inpatient admissions starting in the ED between elderly and younger patients.
Abdullah Ilhan, Umit Yolcu, Salih Altun, Uzeyir Erdem, Fatih C. Gundogan
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.055
Publication stage: In Press Accepted Manuscript
Published online: December 29 2014
x We have read the article entitled “Neuroretinitis Secondary to Bartonella Henselae in the Emergent Setting” by Ursula et al. with interest [1]. We congratulate the authors that they called attention of the emergency physicians to this rare but momentous condition. We would like to ask for further details and make a contribution to the article.
James B. Martel
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.054
Publication stage: In Press Accepted Manuscript
Published online: December 29 2014
x We appreciate and concur with the added insight on the aspects of our case report. Borreliosis was the initially suspected cause due to the history of a tick bite and a headache. Bartonella henselae and quintana IgG and IgM were drawn, which showed positivity for B. henselae. PCR analysis of blood or anterior chamber paracentesis was not utilized, however, this would have greatly supported this diagnosis.
Catherine Kelly, Steven Sattler, Adam Schwartz
DOI: http://dx.doi.org/10.1016/j.ajem.2014.10.028
Publication stage: In Press Accepted Manuscript
Published online: October 16 2014
x The presentation of an ill appearing patient with profuse diarrhea should raise a concern for systemic effects beyond dehydration. We describe a woman who presented to the Emergency Department (ED) due to severe diarrhea who had a significant coagulopathy secondary to depletion of vitamin K dependent clotting factors. Case A 31 year old female presented to the ED complaining of generalized weakness, abdominal cramping, and profuse diarrhea. The symptoms began after initiation of chemotherapy for gastric adenocarcinoma.
Qin Li, MingJun Bi, WeiKang Bi, Hai Kang, LeJing Yan, Yun-liang Guo
DOI: http://dx.doi.org/10.1016/j.ajem.2014.09.013
Publication stage: In Press Corrected Proof
Published online: September 18 2014
x This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy .
Miriam Bortnik, Monica Verdoia, Alon Schaffer, Anna Degiovanni, Paolo Marino
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.009
Publication stage: In Press Accepted Manuscript
Published online: March 17 2014
x This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.
Rimpi Singla, Neelam Aggarwal, Vanita Suri, Pooja Sikka, Arunanshu Behera, Anil Bhansali
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.023
Publication stage: In Press Accepted Manuscript
Published online: February 26 2014
x Neuroendocrine tumors adversely affect the pregnancy outcome, if remain undiagnosed or untreated. Management of such a patient is challenging, especially while weighing the advantages and disadvantages of surgical and medical treatment during early pregnancy. The Case We present the case of a pregnant woman who presented to us with hypertension, episodes of headache, sweating and palpitations. On investigation, she was found to have bilateral heterogenous adrenal masses, a hypervascular lesion inferior to the aortic bifurcation, multiple hypervascular masses with calcifications in the pancreas, and thrombosis of the splenic vein.
